| NPI | 1972512408 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology, Gynecology (Licence: MD D0040683) |
| Additional Taxonomies | 207V00000X Obstetrics & Gynecology (Licence: DC MD20163) |
| Enumeration Date | 2006-08-05 |
| Last Update Date | 2017-04-04 |